BABESIA SPECIES BABESIA SPECIES • ZOONOSIS ZOONOSIS • Vector-IXODID tick Vector-IXODID tick • Resorvoir host-mice,voles and Resorvoir host-mice,voles and other rodents other rodents • Babesia microti-common cause of Babesia microti-common cause of babesiosis in US babesiosis in US
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BABESIA SPECIESBABESIA SPECIES
• ZOONOSISZOONOSIS
• Vector-IXODID tickVector-IXODID tick
• Resorvoir host-mice,voles and other Resorvoir host-mice,voles and other rodentsrodents
• Babesia microti-common cause of Babesia microti-common cause of babesiosis in USbabesiosis in US
• In RBC-trophozoites by binary fission In RBC-trophozoites by binary fission forms tetrad-lyse erythrocytes-forms tetrad-lyse erythrocytes-release merozoites-reinfectrelease merozoites-reinfect
• Infected cells-ingested by ticks-Infected cells-ingested by ticks-transovarian transmissiontransovarian transmission
• Microscopic examination of blood Microscopic examination of blood smearssmears
• Resemble the ring forms of Resemble the ring forms of Plasmodium speciesPlasmodium species
• But no pigment or other stages of But no pigment or other stages of growth as in plasmodium growth as in plasmodium
Treatment and controlTreatment and control
• DOC-Clindamycin+quinineDOC-Clindamycin+quinine
• Exchange blood transfusion in pts Exchange blood transfusion in pts who had splenenctomy and severe who had splenenctomy and severe infectionsinfections
• Diagnostic stage-immature oocyst in Diagnostic stage-immature oocyst in fecesfeces
• Some trophozoite forms-crescentic Some trophozoite forms-crescentic tachyzoites-responsible for initial tachyzoites-responsible for initial infectioninfection
• Slow growing shorter forms-Slow growing shorter forms-bradyzoites-cysts in chronic infectionbradyzoites-cysts in chronic infection
• More severe CNS disease in More severe CNS disease in immunocompromised individualsimmunocompromised individuals
Clinical featuresClinical features
• Mostly-benign and asymptomaticMostly-benign and asymptomatic
• Serological testing-increasing Serological testing-increasing antibody titreantibody titre
• ELISA for IgM AbELISA for IgM Ab
• Demonstrating trophozoites and Demonstrating trophozoites and cysts in tissue and body fluids–cysts in tissue and body fluids–defenitive methoddefenitive method
• Biopsy specimens Biopsy specimens
• Monoclonal antibody based stainingMonoclonal antibody based staining
• Culture methodsCulture methods
TreatmentTreatment
• Pyrimethamine+sulfadiazine high Pyrimethamine+sulfadiazine high dose,then continued in lower dose dose,then continued in lower dose indefenitelyindefenitely
• Trimethoprim-sulfamethoxazole is Trimethoprim-sulfamethoxazole is another optionanother option
• Naegleria trophozoites - in brain on Naegleria trophozoites - in brain on postmortempostmortem
• Acanthameoba and balamuthia-Acanthameoba and balamuthia-granulomatous amoebic encephalitis granulomatous amoebic encephalitis and brain abscess in and brain abscess in immunocompromised individualsimmunocompromised individuals
• Acanthamoeba-keratitis(contact with Acanthamoeba-keratitis(contact with contact lens,soil,dust)contact lens,soil,dust)
• Winterbottom's sign is the swelling of Winterbottom's sign is the swelling of lymph nodeslymph nodes ( (lymphadenopathylymphadenopathy) along ) along the back of the neck, in the the back of the neck, in the posterior cervicalposterior cervical chain of lymph nodes, chain of lymph nodes, as trypanosomes travel in the as trypanosomes travel in the lymphatic fluidlymphatic fluid and cause and cause inflammationinflammation..
• It may be suggestive of cerebral It may be suggestive of cerebral infection.infection.